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Service Code HCPCS C9359
Hospital Charge Code 27000053
Hospital Revenue Code 272
Min. Negotiated Rate $923.91
Max. Negotiated Rate $6,822.72
Rate for Payer: Aetna Commercial $5,472.39
Rate for Payer: Anthem POS/PPO/Traditional $5,543.46
Rate for Payer: Cash Price $3,553.50
Rate for Payer: Cigna Commercial $5,898.81
Rate for Payer: First Health Commercial $6,751.65
Rate for Payer: Humana Commercial $6,040.95
Rate for Payer: Medical Mutual Of Ohio HMO $5,827.74
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $5,244.97
Rate for Payer: Molina Healthcare Benefit Exchange $2,132.10
Rate for Payer: Ohio Health Choice Commercial $6,254.16
Rate for Payer: Ohio Health Group HMO $5,330.25
Rate for Payer: Ohio Health Group PPO Differential $1,421.40
Rate for Payer: Ohio Health Group PPO No Differential $923.91
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,203.17
Rate for Payer: PHCS Commercial $6,822.72
Rate for Payer: United Healthcare All Payer $6,254.16
Service Code CPT 67036
Hospital Revenue Code 360
Min. Negotiated Rate $3,515.95
Max. Negotiated Rate $4,922.33
Rate for Payer: Anthem Medicare Advantage/PPO $3,515.95
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $4,922.33
Rate for Payer: CareSource Just4Me Medicare $4,746.53
Rate for Payer: Humana Medicare Advantage $3,515.95
Rate for Payer: Molina Healthcare Benefit Exchange $4,219.14
Service Code NDC 54021125
Hospital Charge Code 25001695
Hospital Revenue Code 637
Min. Negotiated Rate $1.66
Max. Negotiated Rate $12.27
Rate for Payer: Aetna Commercial $9.84
Rate for Payer: Anthem Medicaid $4.40
Rate for Payer: Anthem POS/PPO/Traditional $9.97
Rate for Payer: Cash Price $6.39
Rate for Payer: Cigna Commercial $10.61
Rate for Payer: First Health Commercial $12.14
Rate for Payer: Humana Commercial $10.86
Rate for Payer: Humana KY Medicaid $4.40
Rate for Payer: Kentucky WC Medicaid $4.44
Rate for Payer: Medical Mutual Of Ohio HMO $10.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $9.43
Rate for Payer: Molina Healthcare Benefit Exchange $3.83
Rate for Payer: Molina Healthcare Medicaid $4.48
Rate for Payer: Ohio Health Choice Commercial $11.25
Rate for Payer: Ohio Health Group HMO $9.58
Rate for Payer: Ohio Health Group PPO Differential $2.56
Rate for Payer: Ohio Health Group PPO No Differential $1.66
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.96
Rate for Payer: PHCS Commercial $12.27
Rate for Payer: United Healthcare All Payer $11.25
Service Code NDC 54021125
Hospital Charge Code 25001695
Hospital Revenue Code 637
Min. Negotiated Rate $1.66
Max. Negotiated Rate $12.27
Rate for Payer: Humana Commercial $10.86
Rate for Payer: Medical Mutual Of Ohio HMO $10.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $9.43
Rate for Payer: Molina Healthcare Benefit Exchange $3.83
Rate for Payer: Ohio Health Choice Commercial $11.25
Rate for Payer: Ohio Health Group HMO $9.58
Rate for Payer: Ohio Health Group PPO Differential $2.56
Rate for Payer: Ohio Health Group PPO No Differential $1.66
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.96
Rate for Payer: PHCS Commercial $12.27
Rate for Payer: United Healthcare All Payer $11.25
Rate for Payer: Aetna Commercial $9.84
Rate for Payer: Anthem POS/PPO/Traditional $9.97
Rate for Payer: Cash Price $6.39
Rate for Payer: Cigna Commercial $10.61
Rate for Payer: First Health Commercial $12.14
Service Code NDC 54021025
Hospital Charge Code 25001696
Hospital Revenue Code 637
Min. Negotiated Rate $1.66
Max. Negotiated Rate $12.27
Rate for Payer: Aetna Commercial $9.84
Rate for Payer: Anthem POS/PPO/Traditional $9.97
Rate for Payer: Cash Price $6.39
Rate for Payer: Cigna Commercial $10.61
Rate for Payer: First Health Commercial $12.14
Rate for Payer: Humana Commercial $10.86
Rate for Payer: Medical Mutual Of Ohio HMO $10.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $9.43
Rate for Payer: Molina Healthcare Benefit Exchange $3.83
Rate for Payer: Ohio Health Choice Commercial $11.25
Rate for Payer: Ohio Health Group HMO $9.58
Rate for Payer: Ohio Health Group PPO Differential $2.56
Rate for Payer: Ohio Health Group PPO No Differential $1.66
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.96
Rate for Payer: PHCS Commercial $12.27
Rate for Payer: United Healthcare All Payer $11.25
Service Code NDC 54021025
Hospital Charge Code 25001696
Hospital Revenue Code 637
Min. Negotiated Rate $1.66
Max. Negotiated Rate $12.27
Rate for Payer: Aetna Commercial $9.84
Rate for Payer: Anthem Medicaid $4.40
Rate for Payer: Anthem POS/PPO/Traditional $9.97
Rate for Payer: Cash Price $6.39
Rate for Payer: Cigna Commercial $10.61
Rate for Payer: First Health Commercial $12.14
Rate for Payer: Humana Commercial $10.86
Rate for Payer: Humana KY Medicaid $4.40
Rate for Payer: Kentucky WC Medicaid $4.44
Rate for Payer: Medical Mutual Of Ohio HMO $10.48
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $9.43
Rate for Payer: Molina Healthcare Benefit Exchange $3.83
Rate for Payer: Molina Healthcare Medicaid $4.48
Rate for Payer: Ohio Health Choice Commercial $11.25
Rate for Payer: Ohio Health Group HMO $9.58
Rate for Payer: Ohio Health Group PPO Differential $2.56
Rate for Payer: Ohio Health Group PPO No Differential $1.66
Rate for Payer: Ohio Health Group PPO SOMC Employees $3.96
Rate for Payer: PHCS Commercial $12.27
Rate for Payer: United Healthcare All Payer $11.25
Service Code NDC 46017001816
Hospital Charge Code 25001697
Hospital Revenue Code 637
Min. Negotiated Rate $0.56
Max. Negotiated Rate $4.17
Rate for Payer: Aetna Commercial $3.34
Rate for Payer: Anthem POS/PPO/Traditional $3.39
Rate for Payer: Cash Price $2.17
Rate for Payer: Cigna Commercial $3.60
Rate for Payer: First Health Commercial $4.12
Rate for Payer: Humana Commercial $3.69
Rate for Payer: Medical Mutual Of Ohio HMO $3.56
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.20
Rate for Payer: Molina Healthcare Benefit Exchange $1.30
Rate for Payer: Ohio Health Choice Commercial $3.82
Rate for Payer: Ohio Health Group HMO $3.26
Rate for Payer: Ohio Health Group PPO Differential $0.87
Rate for Payer: Ohio Health Group PPO No Differential $0.56
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.35
Rate for Payer: PHCS Commercial $4.17
Rate for Payer: United Healthcare All Payer $3.82
Service Code NDC 46017001816
Hospital Charge Code 25001697
Hospital Revenue Code 637
Min. Negotiated Rate $0.56
Max. Negotiated Rate $4.17
Rate for Payer: Aetna Commercial $3.34
Rate for Payer: Anthem Medicaid $1.49
Rate for Payer: Anthem POS/PPO/Traditional $3.39
Rate for Payer: Cash Price $2.17
Rate for Payer: Cigna Commercial $3.60
Rate for Payer: First Health Commercial $4.12
Rate for Payer: Humana Commercial $3.69
Rate for Payer: Humana KY Medicaid $1.49
Rate for Payer: Kentucky WC Medicaid $1.51
Rate for Payer: Medical Mutual Of Ohio HMO $3.56
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $3.20
Rate for Payer: Molina Healthcare Benefit Exchange $1.30
Rate for Payer: Molina Healthcare Medicaid $1.52
Rate for Payer: Ohio Health Choice Commercial $3.82
Rate for Payer: Ohio Health Group HMO $3.26
Rate for Payer: Ohio Health Group PPO Differential $0.87
Rate for Payer: Ohio Health Group PPO No Differential $0.56
Rate for Payer: Ohio Health Group PPO SOMC Employees $1.35
Rate for Payer: PHCS Commercial $4.17
Rate for Payer: United Healthcare All Payer $3.82
Service Code HCPCS J2315
Hospital Charge Code 63600146
Hospital Revenue Code 636
Min. Negotiated Rate $2.86
Max. Negotiated Rate $21.09
Rate for Payer: Aetna Commercial $16.92
Rate for Payer: Anthem POS/PPO/Traditional $17.14
Rate for Payer: Cash Price $10.98
Rate for Payer: Cigna Commercial $18.24
Rate for Payer: First Health Commercial $20.87
Rate for Payer: Humana Commercial $18.67
Rate for Payer: Medical Mutual Of Ohio HMO $18.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $16.21
Rate for Payer: Molina Healthcare Benefit Exchange $6.59
Rate for Payer: Ohio Health Choice Commercial $19.33
Rate for Payer: Ohio Health Group HMO $16.48
Rate for Payer: Ohio Health Group PPO Differential $4.39
Rate for Payer: Ohio Health Group PPO No Differential $2.86
Rate for Payer: Ohio Health Group PPO SOMC Employees $6.81
Rate for Payer: PHCS Commercial $21.09
Rate for Payer: United Healthcare All Payer $19.33
Service Code HCPCS J2315
Hospital Charge Code 25004089
Hospital Revenue Code 636
Min. Negotiated Rate $3.96
Max. Negotiated Rate $8,586.29
Rate for Payer: Aetna Commercial $6,886.92
Rate for Payer: Anthem Medicaid $3,075.86
Rate for Payer: Anthem Medicare Advantage/PPO $3.96
Rate for Payer: Anthem POS/PPO/Traditional $6,976.36
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $5.54
Rate for Payer: CareSource Just4Me Medicare $5.34
Rate for Payer: Cash Price $4,472.02
Rate for Payer: Cash Price $4,472.02
Rate for Payer: Cigna Commercial $7,423.56
Rate for Payer: First Health Commercial $8,496.85
Rate for Payer: Humana Commercial $7,602.44
Rate for Payer: Humana KY Medicaid $3,075.86
Rate for Payer: Humana Medicare Advantage $3.96
Rate for Payer: Kentucky WC Medicaid $3,107.16
Rate for Payer: Medical Mutual Of Ohio HMO $7,334.12
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,600.71
Rate for Payer: Molina Healthcare Benefit Exchange $4.75
Rate for Payer: Molina Healthcare Medicaid $3,137.57
Rate for Payer: Ohio Health Choice Commercial $7,870.76
Rate for Payer: Ohio Health Group HMO $6,708.04
Rate for Payer: Ohio Health Group PPO Differential $1,788.81
Rate for Payer: Ohio Health Group PPO No Differential $1,162.73
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,772.66
Rate for Payer: PHCS Commercial $8,586.29
Rate for Payer: United Healthcare All Payer $7,870.76
Service Code HCPCS J2315
Hospital Charge Code 63600146
Hospital Revenue Code 636
Min. Negotiated Rate $2.54
Max. Negotiated Rate $21.97
Rate for Payer: Aetna Commercial $4.83
Rate for Payer: Buckeye Medicare Advantage $21.97
Rate for Payer: Cash Price $10.98
Rate for Payer: Cash Price $10.98
Rate for Payer: Healthspan PPO $2.54
Rate for Payer: Medical Mutual Of Ohio HMO/POS/PPO/Workers Compensation $4.86
Rate for Payer: Multiplan PHCS $13.18
Rate for Payer: Ohio Health Choice Preferred Health Choice $15.38
Rate for Payer: UHCCP Medicaid $7.69
Service Code HCPCS J2315
Hospital Charge Code 636T0146
Hospital Revenue Code 636
Min. Negotiated Rate $2.86
Max. Negotiated Rate $21.09
Rate for Payer: Aetna Commercial $16.92
Rate for Payer: Anthem Medicaid $7.56
Rate for Payer: Anthem Medicare Advantage/PPO $3.96
Rate for Payer: Anthem POS/PPO/Traditional $17.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $5.54
Rate for Payer: CareSource Just4Me Medicare $5.34
Rate for Payer: Cash Price $10.98
Rate for Payer: Cash Price $10.98
Rate for Payer: Cigna Commercial $18.24
Rate for Payer: First Health Commercial $20.87
Rate for Payer: Humana Commercial $18.67
Rate for Payer: Humana KY Medicaid $7.56
Rate for Payer: Humana Medicare Advantage $3.96
Rate for Payer: Kentucky WC Medicaid $7.63
Rate for Payer: Medical Mutual Of Ohio HMO $18.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $16.21
Rate for Payer: Molina Healthcare Benefit Exchange $4.75
Rate for Payer: Molina Healthcare Medicaid $7.71
Rate for Payer: Ohio Health Choice Commercial $19.33
Rate for Payer: Ohio Health Group HMO $16.48
Rate for Payer: Ohio Health Group PPO Differential $4.39
Rate for Payer: Ohio Health Group PPO No Differential $2.86
Rate for Payer: Ohio Health Group PPO SOMC Employees $6.81
Rate for Payer: PHCS Commercial $21.09
Rate for Payer: United Healthcare All Payer $19.33
Service Code HCPCS J2315
Hospital Charge Code 63600146
Hospital Revenue Code 636
Min. Negotiated Rate $2.86
Max. Negotiated Rate $21.09
Rate for Payer: Aetna Commercial $16.92
Rate for Payer: Anthem Medicaid $7.56
Rate for Payer: Anthem Medicare Advantage/PPO $3.96
Rate for Payer: Anthem POS/PPO/Traditional $17.14
Rate for Payer: Buckeye Individual/Medicaid/Medicare Advantage $5.54
Rate for Payer: CareSource Just4Me Medicare $5.34
Rate for Payer: Cash Price $10.98
Rate for Payer: Cash Price $10.98
Rate for Payer: Cigna Commercial $18.24
Rate for Payer: First Health Commercial $20.87
Rate for Payer: Humana Commercial $18.67
Rate for Payer: Humana KY Medicaid $7.56
Rate for Payer: Humana Medicare Advantage $3.96
Rate for Payer: Kentucky WC Medicaid $7.63
Rate for Payer: Medical Mutual Of Ohio HMO $18.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $16.21
Rate for Payer: Molina Healthcare Benefit Exchange $4.75
Rate for Payer: Molina Healthcare Medicaid $7.71
Rate for Payer: Ohio Health Choice Commercial $19.33
Rate for Payer: Ohio Health Group HMO $16.48
Rate for Payer: Ohio Health Group PPO Differential $4.39
Rate for Payer: Ohio Health Group PPO No Differential $2.86
Rate for Payer: Ohio Health Group PPO SOMC Employees $6.81
Rate for Payer: PHCS Commercial $21.09
Rate for Payer: United Healthcare All Payer $19.33
Service Code HCPCS J2315
Hospital Charge Code 25004089
Hospital Revenue Code 636
Min. Negotiated Rate $1,162.73
Max. Negotiated Rate $8,586.29
Rate for Payer: Aetna Commercial $6,886.92
Rate for Payer: Anthem POS/PPO/Traditional $6,976.36
Rate for Payer: Cash Price $4,472.02
Rate for Payer: Cigna Commercial $7,423.56
Rate for Payer: First Health Commercial $8,496.85
Rate for Payer: Humana Commercial $7,602.44
Rate for Payer: Medical Mutual Of Ohio HMO $7,334.12
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $6,600.71
Rate for Payer: Molina Healthcare Benefit Exchange $2,683.22
Rate for Payer: Ohio Health Choice Commercial $7,870.76
Rate for Payer: Ohio Health Group HMO $6,708.04
Rate for Payer: Ohio Health Group PPO Differential $1,788.81
Rate for Payer: Ohio Health Group PPO No Differential $1,162.73
Rate for Payer: Ohio Health Group PPO SOMC Employees $2,772.66
Rate for Payer: PHCS Commercial $8,586.29
Rate for Payer: United Healthcare All Payer $7,870.76
Service Code HCPCS J2315
Hospital Charge Code 636T0146
Hospital Revenue Code 636
Min. Negotiated Rate $2.86
Max. Negotiated Rate $21.09
Rate for Payer: Aetna Commercial $16.92
Rate for Payer: Anthem POS/PPO/Traditional $17.14
Rate for Payer: Cash Price $10.98
Rate for Payer: Cigna Commercial $18.24
Rate for Payer: First Health Commercial $20.87
Rate for Payer: Humana Commercial $18.67
Rate for Payer: Medical Mutual Of Ohio HMO $18.02
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $16.21
Rate for Payer: Molina Healthcare Benefit Exchange $6.59
Rate for Payer: Ohio Health Choice Commercial $19.33
Rate for Payer: Ohio Health Group HMO $16.48
Rate for Payer: Ohio Health Group PPO Differential $4.39
Rate for Payer: Ohio Health Group PPO No Differential $2.86
Rate for Payer: Ohio Health Group PPO SOMC Employees $6.81
Rate for Payer: PHCS Commercial $21.09
Rate for Payer: United Healthcare All Payer $19.33
Service Code HCPCS V2788
Hospital Charge Code 27000231
Hospital Revenue Code 276
Min. Negotiated Rate $738.72
Max. Negotiated Rate $5,455.20
Rate for Payer: Aetna Commercial $4,375.52
Rate for Payer: Anthem POS/PPO/Traditional $4,432.35
Rate for Payer: Cash Price $2,841.25
Rate for Payer: Cigna Commercial $4,716.48
Rate for Payer: First Health Commercial $5,398.38
Rate for Payer: Humana Commercial $4,830.12
Rate for Payer: Medical Mutual Of Ohio HMO $4,659.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,193.68
Rate for Payer: Molina Healthcare Benefit Exchange $1,704.75
Rate for Payer: Ohio Health Choice Commercial $5,000.60
Rate for Payer: Ohio Health Group HMO $4,261.88
Rate for Payer: Ohio Health Group PPO Differential $1,136.50
Rate for Payer: Ohio Health Group PPO No Differential $738.72
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,761.58
Rate for Payer: PHCS Commercial $5,455.20
Rate for Payer: United Healthcare All Payer $5,000.60
Service Code HCPCS V2788
Hospital Charge Code 27000231
Hospital Revenue Code 276
Min. Negotiated Rate $738.72
Max. Negotiated Rate $5,455.20
Rate for Payer: Aetna Commercial $4,375.52
Rate for Payer: Anthem Medicaid $1,954.21
Rate for Payer: Anthem POS/PPO/Traditional $4,432.35
Rate for Payer: Cash Price $2,841.25
Rate for Payer: Cigna Commercial $4,716.48
Rate for Payer: First Health Commercial $5,398.38
Rate for Payer: Humana Commercial $4,830.12
Rate for Payer: Humana KY Medicaid $1,954.21
Rate for Payer: Kentucky WC Medicaid $1,974.10
Rate for Payer: Medical Mutual Of Ohio HMO $4,659.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,193.68
Rate for Payer: Molina Healthcare Benefit Exchange $1,704.75
Rate for Payer: Molina Healthcare Medicaid $1,993.42
Rate for Payer: Ohio Health Choice Commercial $5,000.60
Rate for Payer: Ohio Health Group HMO $4,261.88
Rate for Payer: Ohio Health Group PPO Differential $1,136.50
Rate for Payer: Ohio Health Group PPO No Differential $738.72
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,761.58
Rate for Payer: PHCS Commercial $5,455.20
Rate for Payer: United Healthcare All Payer $5,000.60
Service Code HCPCS V2788
Hospital Charge Code 27000231
Hospital Revenue Code 276
Min. Negotiated Rate $718.25
Max. Negotiated Rate $5,304.00
Rate for Payer: Aetna Commercial $4,254.25
Rate for Payer: Anthem POS/PPO/Traditional $4,309.50
Rate for Payer: Cash Price $2,762.50
Rate for Payer: Cigna Commercial $4,585.75
Rate for Payer: First Health Commercial $5,248.75
Rate for Payer: Humana Commercial $4,696.25
Rate for Payer: Medical Mutual Of Ohio HMO $4,530.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,077.45
Rate for Payer: Molina Healthcare Benefit Exchange $1,657.50
Rate for Payer: Ohio Health Choice Commercial $4,862.00
Rate for Payer: Ohio Health Group HMO $4,143.75
Rate for Payer: Ohio Health Group PPO Differential $1,105.00
Rate for Payer: Ohio Health Group PPO No Differential $718.25
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,712.75
Rate for Payer: PHCS Commercial $5,304.00
Rate for Payer: United Healthcare All Payer $4,862.00
Service Code HCPCS V2788
Hospital Charge Code 27000231
Hospital Revenue Code 276
Min. Negotiated Rate $718.25
Max. Negotiated Rate $5,304.00
Rate for Payer: Aetna Commercial $4,254.25
Rate for Payer: Anthem Medicaid $1,900.05
Rate for Payer: Anthem POS/PPO/Traditional $4,309.50
Rate for Payer: Cash Price $2,762.50
Rate for Payer: Cigna Commercial $4,585.75
Rate for Payer: First Health Commercial $5,248.75
Rate for Payer: Humana Commercial $4,696.25
Rate for Payer: Humana KY Medicaid $1,900.05
Rate for Payer: Kentucky WC Medicaid $1,919.38
Rate for Payer: Medical Mutual Of Ohio HMO $4,530.50
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,077.45
Rate for Payer: Molina Healthcare Benefit Exchange $1,657.50
Rate for Payer: Molina Healthcare Medicaid $1,938.17
Rate for Payer: Ohio Health Choice Commercial $4,862.00
Rate for Payer: Ohio Health Group HMO $4,143.75
Rate for Payer: Ohio Health Group PPO Differential $1,105.00
Rate for Payer: Ohio Health Group PPO No Differential $718.25
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,712.75
Rate for Payer: PHCS Commercial $5,304.00
Rate for Payer: United Healthcare All Payer $4,862.00
Service Code HCPCS V2788
Hospital Charge Code 27000231
Hospital Revenue Code 276
Min. Negotiated Rate $738.72
Max. Negotiated Rate $5,455.20
Rate for Payer: Aetna Commercial $4,375.52
Rate for Payer: Anthem POS/PPO/Traditional $4,432.35
Rate for Payer: Cash Price $2,841.25
Rate for Payer: Cigna Commercial $4,716.48
Rate for Payer: First Health Commercial $5,398.38
Rate for Payer: Humana Commercial $4,830.12
Rate for Payer: Medical Mutual Of Ohio HMO $4,659.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,193.68
Rate for Payer: Molina Healthcare Benefit Exchange $1,704.75
Rate for Payer: Ohio Health Choice Commercial $5,000.60
Rate for Payer: Ohio Health Group HMO $4,261.88
Rate for Payer: Ohio Health Group PPO Differential $1,136.50
Rate for Payer: Ohio Health Group PPO No Differential $738.72
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,761.58
Rate for Payer: PHCS Commercial $5,455.20
Rate for Payer: United Healthcare All Payer $5,000.60
Service Code HCPCS V2788
Hospital Charge Code 27000231
Hospital Revenue Code 276
Min. Negotiated Rate $738.72
Max. Negotiated Rate $5,455.20
Rate for Payer: Aetna Commercial $4,375.52
Rate for Payer: Anthem Medicaid $1,954.21
Rate for Payer: Anthem POS/PPO/Traditional $4,432.35
Rate for Payer: Cash Price $2,841.25
Rate for Payer: Cigna Commercial $4,716.48
Rate for Payer: First Health Commercial $5,398.38
Rate for Payer: Humana Commercial $4,830.12
Rate for Payer: Humana KY Medicaid $1,954.21
Rate for Payer: Kentucky WC Medicaid $1,974.10
Rate for Payer: Medical Mutual Of Ohio HMO $4,659.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,193.68
Rate for Payer: Molina Healthcare Benefit Exchange $1,704.75
Rate for Payer: Molina Healthcare Medicaid $1,993.42
Rate for Payer: Ohio Health Choice Commercial $5,000.60
Rate for Payer: Ohio Health Group HMO $4,261.88
Rate for Payer: Ohio Health Group PPO Differential $1,136.50
Rate for Payer: Ohio Health Group PPO No Differential $738.72
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,761.58
Rate for Payer: PHCS Commercial $5,455.20
Rate for Payer: United Healthcare All Payer $5,000.60
Service Code HCPCS V2788
Hospital Charge Code 27000231
Hospital Revenue Code 276
Min. Negotiated Rate $738.72
Max. Negotiated Rate $5,455.20
Rate for Payer: Aetna Commercial $4,375.52
Rate for Payer: Anthem POS/PPO/Traditional $4,432.35
Rate for Payer: Cash Price $2,841.25
Rate for Payer: Cigna Commercial $4,716.48
Rate for Payer: First Health Commercial $5,398.38
Rate for Payer: Humana Commercial $4,830.12
Rate for Payer: Medical Mutual Of Ohio HMO $4,659.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,193.68
Rate for Payer: Molina Healthcare Benefit Exchange $1,704.75
Rate for Payer: Ohio Health Choice Commercial $5,000.60
Rate for Payer: Ohio Health Group HMO $4,261.88
Rate for Payer: Ohio Health Group PPO Differential $1,136.50
Rate for Payer: Ohio Health Group PPO No Differential $738.72
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,761.58
Rate for Payer: PHCS Commercial $5,455.20
Rate for Payer: United Healthcare All Payer $5,000.60
Service Code HCPCS V2788
Hospital Charge Code 27000231
Hospital Revenue Code 276
Min. Negotiated Rate $738.72
Max. Negotiated Rate $5,455.20
Rate for Payer: Aetna Commercial $4,375.52
Rate for Payer: Anthem Medicaid $1,954.21
Rate for Payer: Anthem POS/PPO/Traditional $4,432.35
Rate for Payer: Cash Price $2,841.25
Rate for Payer: Cigna Commercial $4,716.48
Rate for Payer: First Health Commercial $5,398.38
Rate for Payer: Humana Commercial $4,830.12
Rate for Payer: Humana KY Medicaid $1,954.21
Rate for Payer: Kentucky WC Medicaid $1,974.10
Rate for Payer: Medical Mutual Of Ohio HMO $4,659.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $4,193.68
Rate for Payer: Molina Healthcare Benefit Exchange $1,704.75
Rate for Payer: Molina Healthcare Medicaid $1,993.42
Rate for Payer: Ohio Health Choice Commercial $5,000.60
Rate for Payer: Ohio Health Group HMO $4,261.88
Rate for Payer: Ohio Health Group PPO Differential $1,136.50
Rate for Payer: Ohio Health Group PPO No Differential $738.72
Rate for Payer: Ohio Health Group PPO SOMC Employees $1,761.58
Rate for Payer: PHCS Commercial $5,455.20
Rate for Payer: United Healthcare All Payer $5,000.60
Service Code HCPCS B4153
Hospital Charge Code 25001807
Hospital Revenue Code 637
Min. Negotiated Rate $12.47
Max. Negotiated Rate $92.08
Rate for Payer: Aetna Commercial $73.86
Rate for Payer: Anthem POS/PPO/Traditional $74.82
Rate for Payer: Cash Price $47.96
Rate for Payer: Cigna Commercial $79.61
Rate for Payer: First Health Commercial $91.12
Rate for Payer: Humana Commercial $81.53
Rate for Payer: Medical Mutual Of Ohio HMO $78.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $70.79
Rate for Payer: Molina Healthcare Benefit Exchange $28.78
Rate for Payer: Ohio Health Choice Commercial $84.41
Rate for Payer: Ohio Health Group HMO $71.94
Rate for Payer: Ohio Health Group PPO Differential $19.18
Rate for Payer: Ohio Health Group PPO No Differential $12.47
Rate for Payer: Ohio Health Group PPO SOMC Employees $29.74
Rate for Payer: PHCS Commercial $92.08
Rate for Payer: United Healthcare All Payer $84.41
Service Code HCPCS B4153
Hospital Charge Code 25001807
Hospital Revenue Code 637
Min. Negotiated Rate $12.47
Max. Negotiated Rate $92.08
Rate for Payer: Aetna Commercial $73.86
Rate for Payer: Anthem Medicaid $32.99
Rate for Payer: Anthem POS/PPO/Traditional $74.82
Rate for Payer: Cash Price $47.96
Rate for Payer: Cigna Commercial $79.61
Rate for Payer: First Health Commercial $91.12
Rate for Payer: Humana Commercial $81.53
Rate for Payer: Humana KY Medicaid $32.99
Rate for Payer: Kentucky WC Medicaid $33.32
Rate for Payer: Medical Mutual Of Ohio HMO $78.65
Rate for Payer: Medical Mutual Of Ohio POS/PPO/Traditional $70.79
Rate for Payer: Molina Healthcare Benefit Exchange $28.78
Rate for Payer: Molina Healthcare Medicaid $33.65
Rate for Payer: Ohio Health Choice Commercial $84.41
Rate for Payer: Ohio Health Group HMO $71.94
Rate for Payer: Ohio Health Group PPO Differential $19.18
Rate for Payer: Ohio Health Group PPO No Differential $12.47
Rate for Payer: Ohio Health Group PPO SOMC Employees $29.74
Rate for Payer: PHCS Commercial $92.08
Rate for Payer: United Healthcare All Payer $84.41